"I would tell him not to drive": Neurologist says Trump most likely Suffering from Frontotemporal Dementia
Dr. Cheryl Faber Discusses Various Types of Dementia and What Form of Dementia Trump is most likely Suffering from
[Writer Notes: I’ve gotten a lot of comments about how Trump doesn’t know how to drive, or he hasn’t driven in a long time, etc. That isn’t the point of her remark. The neurologist’s point is that he is so dangerous, he shouldn’t be behind the wheel of a car. Thanks!]
A few days ago, I spoke with Dr. Cheryl Faber, a general neurologist with a practice in the St. Louis area. I’m providing her bio here and our talk below that:
Dr. Cheryl Faber earned a B.A. in English and a B.S. in Cell Biology from the University of Kansas. She earned her medical degree and completed her Neurology internship and residency at the University of Kansas Medical School in 2000. Since then, she has provided comprehensive neurological care to the St. Louis community through Neurology Associates at BIC Medical Group. Dr. Faber has expertise in a wide array of neurological conditions. As a general neurologist, she treats the full spectrum of neurological diseases. She partners closely with subspecialty patients when they require subspecialized care. Of special interest to Dr. Faber are conditions that impact brain function, including dementia, Parkinson’s disease, stroke, seizures, multiple sclerosis, and headache disorders. She also treats neuromuscular diseases, including myasthenia gravis, neuropathy, and dystonia. Dr. Faber has extensive training and expertise in the use of botulinum toxin (BOTOX) to treat neurological diseases, including dystonia, spasticity, hemifacial spasm, blepharospasm, and migraine.
Dr. Faber is also passionate about educating patients and the medical community. She has been a patient educator for the National Multiple Sclerosis Society (NMSS), the Multiple Sclerosis Association of America (MSAA), the American Heart Association (AHA), and the American Stroke Association (ASA). She instructs medical residents at Missouri Baptist Medical Center in the art and science of neurological care. Dr. Faber also regularly provides continuing medical (CME) lectures for physicians and allied health care providers on various aspects of neurological illness and treatment.
Dr. Cheryl Faber, who goes by Me on Substack, commented on my piece about President Donald Trump’s cognitive decline on December 6. Dr. Faber agreed with my analysis and also said in her remarks under the article, “Having a dementia patient in charge of the nuclear codes is a frightening reality.” From there, we scheduled an interview for December 17.
It was a cold, windy evening here on the East Coast when I rang up Dr. Faber in St. Louis at 5 o’clock. She was immediately warm, and we started the conversation about her background, and then eased into discussing general things about dementia, Alzheimer’s, frontotemporal dementia, and some of her patients.
“I practice with multiple neurologists,” she told me, “We are either general neurologists or specialize in subspecialities of various types. I’ve been in practice for 25 years here in St. Louis. I do have a large number of patients I see for cognitive disorders. That would be dementia, basically, things we would consider to be neurodegenerative processes, where the brain, or in some cases the spinal cord, is degenerating or deteriorating over time. And a big part of those diseases—neurogenerative diseases—is kind of a blanket term, dementia. Dementia is not one disease. It is a term for a cognitive disease or cognitive disorder. People can have various kinds of dementia, and usually, in the generic sense, when people say they are suffering from dementia, or they are worried they have dementia, they are talking about Alzheimer’s dementia because that is one we see most commonly. But there are other ones.” Dr. Faber also prescribes medications, creates diagnostic work-ups, and, as she said, does “a lot of talking and hand holding.”
I asked her about her routines after she described her background. She said, “As part of my routine, I see patients every day in my office, and some of them have dementia. A lot of what I do for my patients who have dementia is counseling,” she said with a grim laugh, adding, “because there are great limitations to our ability to treat dementia, so a lot of it is counseling for family and caregivers, and going through that process of what their expectations might be, and also what do we do for the person who has dementia—Should they be driving? Should they be managing their own money? Should they be president of the United States? Also, what are the deal breakers? Toileting becomes one of them, along with extreme disinhibition and violent outbursts.
I laughed uncomfortably at the obvious topic we were about to address: the president of the United States and his evident cognitive decline. But before that, Dr. Faber explained the various types of dementia.
She told me there are numerous types of dementia, and she described some of the more common ones:
Alzheimer’s, which is the most common type of dementia, “memory is the primary thing that is affected,” she told me, “But,” she added, “behavior also can become an issue in later years, and that’s why I differentiate between the different types of dementia because certain types of dementia affect behavior more than memory. So, early on, it’s short-term memory loss. People often repeat themselves and ask the same question over and over again.”
Frontotemporal dementia, Dr. Faber told me, “is flipped, it’s the opposite; it affects the frontal and temporal regions of the brain. The frontal part of the brain regulates your decision-making. It also creates inhibition.” When it isn’t working, one can’t regulate thoughts, desires, and decisions. “Which means,” Faber added, “you might be impulsive, you might be rash, you might be quick to anger, and it oftentimes exacerbates underlying character traits, like if someone had previously been aggressive, they might become very aggressive.
People with this form of dementia also develop issues with language. “The frontal part of the brain,” Faber told me, “also controls language. They do a lot of word substitution. They’ll use a combination of words that don’t make sense together—we call that ‘word salad.’ Finally, frontotemporal dementia is much more rapidly progressive.”
“I had to counsel a family with a man with a gun the other night, and I had to get a gun out of the house, because he believed prowlers were out around the house,” she said.
Dementia with Lewy Bodies, this form of dementia is usually associated with Parkinson’s. When people have initial symptoms, Dr. Faber said, “It looks very psychiatric. Patients usually show up with hallucinations and delusions at the beginning. So, their memory might be perfectly fine, but they think that aliens are monitoring their thoughts, or that their neighbors are CIA agents. They also suffer from visual and auditory hallucination, so it has a different flavor [than the other two mentioned].” These patients will eventually develop memory problems, but that usually doesn’t happen for a year or two after their diagnosis.
Ultimately, most patients have “mixed dementia,” Dr. Faber told me. “The only way to prove it is to do a brain biopsy or do an autopsy after death. And, oftentimes, when we do look at the brain, we realize that there is a mix of different types of dementia. But a person with pure Alzheimer’s dementia, if that’s possible, they have a lot of these amyloid plaques that have built up.”
The mention of amyloid plaques led us to discuss Kisulna and Leqembi, two drugs that treat them. One of the side effects of these two drugs, which must be administered intravenously, is that both drugs can cause Amyloid-Related Imaging Abnormalities (ARIA), namely the risk of small brain bleeds (ARIA-H) or the brain swelling (ARIA-E). Therefore, MRIs are required to monitor the patient’s brain health. As I stated in my previous article, it has been noted that Trump has had at least one MRI, which indicates, along with the excessive bruising on his hand, as well as clear signs of cognitive decline, that he is most likely receiving one of these drugs. Dr. Faber agrees with me and also believes that Trump is on one of these drugs, given the bruising on his hand, as I just stated, and how he has mentioned having an MRI. These drugs don’t prevent or reverse the disease; they slow its progression, Faber told me. “But, once again, that’s for people with amyloid plaques, which means having Alzheimer’s dementia.” If someone had pure frontotemporal dementia, it wouldn’t make sense to treat them with this medication, she added, as they are specific for amyloid plaques. “But,” she concluded, “we never know 100%, and often people have mixed dementia types, and we basically just treat it as if it’s Alzheimer’s, because the drugs we have are all intended for Alzheimer’s.”
We then moved on to discuss Trump further. Dr. Faber is not treating him, but she has observed him closely. She believes he is likely suffering from “some type of dementia,” and it’s most likely frontotemporal dementia. When asked why she thought that, she said, “he seems to be very impulsive, it’s his speech patterns, so he is exhibiting increasing language problems, much more now than he even was 6 months ago.” Dr. Faber also mentioned other related symptoms, like the way in which he walks. His gait has deteriorated, and that is also related to dementia. In addition, leaning forward is another symptom, and Dr. Faber noted that he has trouble going up the stairs now, too. These are all part of his degenerative condition, as it doesn’t just affect the brain, but one’s physical abilities to some extent, too.
One thing Dr. Faber also noted is the rapid decline of Trump, and that, again, is another piece of evidence that points to the likelihood of him suffering from frontotemporal dementia. As I settled into my seat with the winter winds near Trump and me picking up, she said, “So, whatever is happening to him now seems to be happening faster than typical Alzheimer’s dementia.”
I dug deeper into why Dr. Faber thinks Trump has frontotemporal dementia, and she said he seems to also suffer from what is called “confabulation,” which, she told me, is “making up stories or telling stories.” Dr. Faber brought up two examples. One was from a few days ago at a holiday party, she said. She told me that he began to talk about a viper, for instance, and how the viper had bitten him, and he had almost died. This story made me wonder if, in his mind, Trump was trying to revisit the parable of the snake that he used to tell at rallies. (I wrote about this parable earlier when I wrote a book review of Alexander Laban Hinton’s It Can Happen Here: White Power and the Rising Threat of Genocide in the U.S.)1 Obviously, the story came out as nonsense at the holiday party. Dr. Faber added, “as lot of dementia patient do this, they will tell really long stories that go off into different directions, they don’t make a lot of sense, and they will latch onto one thing, and then go onto another topic—the two things won’t make sense together necessarily, except in their own mind. The term for that is ‘loose association.’”
The other story was related to the letter “H.” Dr. Faber explained, “I also remember very specifically, one time, he was talking about Harvard, and he was upset about their admissions practices, and then somehow he started talking about,” and she paused, putting an emphasis on the “H,” here, “Harlem, which in his mind sounded similar to Harvard, so because of the sound—the H sound and sound association—and then he started talking about how everyone in Harlem loves him, and said, ‘The Black people love me,’ and going on a totally different tangent. When that happens, we call that ‘tangential thinking,’ because the train has gone onto another track.”
“People with loose associations and frontotemporal dementia will do a lot of that. They have many loose associations, and their speech patterns do not necessarily follow logically. That’s been happening more with him recently.”
As I was taking in all this information, it struck me as disturbing that we were actually discussing the president of the United States. As the cold winds intensified outside and rapped against my windowpanes, I pulled my sweater closer to me. The softness of my corgi, wrapped around my feet, provided me some comfort, but I couldn’t shake my fear of the fact that the president is most likely suffering from frontotemporal dementia, something that’s preoccupied me for some time. Dr. Faber left me with a lot of angst, but also provided important details for additional assessment. She is convinced that the people close to him have no doubt that he is suffering from frontotemporal dementia, but those of us seeing it publicly, it’s “pretty obvious” too, she concluded.
Women, of course, came up during our conversation. That is, his unmistakable misogyny. Faber and I discussed how he’s always been outwardly misogynistic, but now, with his cognitive decline, it’s worsened (The “Quiet piggy,” “Are you stupid?”, and other insulting remarks). And even when his comments are “positive,” such as the ones he made about White House Press Secretary Karoline Leavitt (”Look at those lips, they rattle on like a machine gun”), they are still incredibly inappropriate. It’s clear that he is exhibiting disinhibition, and it seems to worsen by the day. Faber thinks these are examples of previous behavior, “an exaggeration of that,” she said, “and his personality, but taken to another level.” (Faber also mentioned that he seems to really go after women of color, too.) As of this writing, Trump talked about his wife’s “panties” at a rally on December 19.
I wanted to know more about what Faber thought of his competency, which she said she couldn’t judge. However, she did say, “Is it a good idea for a person with dementia, even if it’s in the early stages, to be in charge of running a country? And if he were in my office as a patient, I would say, with the things we’ve seen, and if he were not president of the United States, I would definitely ask family members to be supervising him to make sure he’s taking his medication. I would probably advise him not to drive. When people have trouble controlling their impulses, driving can be dangerous. People with frontotemporal dementia are well-known for causing all sorts of problems with road rage.”
I paused for a moment after she said these things, took a deep breath, listened more to the howling wind, and said, “That’s really chilling. You said that if he were your patient, you probably would not have him driving. Think about that for a moment. He’s the president of the United States of America.” The hair on my arms stood up, and chills ran down my spine. I held myself close and was grateful for the warmth from my dog.
“Well, Trump needs supervision, and the team around him is not providing supervision. That’s a problem.”
That did it. That jolted me so much that I woke my dog. She got up and left. As Dr. Faber continued to talk, I listened as my corgi drank water from her bowl downstairs. The soft rhythm of her tongue lapping up the water assured me that things were normal, although Dr. Faber’s words were telling me otherwise.
“We know that Ronald Reagan had Alzheimer’s disease in his later years, and it probably did start while he was president. But he did have people around who could support him. I don’t know if that was an ideal situation either, but it wasn’t as dangerous as our current situation. So, it is a problem, because a person with this type of dementia is going to need help, and they are going to need support from people around them to keep an eye on things, make sure they are making good choices, and make sure they are making good decisions, and they shouldn’t be making important decisions for other people.”
My anxiety levels had reached a fever-pitch by this point when she said that, as Trump is making major decisions not just for people in this country, but for people across the globe. My dog had returned to rest at my feet, but unfortunately, she was giving me little comfort. My blood ran cold, and my hands were numb.
Again, I repeated what I said above, “That’s just really disturbing to me—about the driving—that if he were in your office, you would tell him not to drive.”
She laughed grimly again and said, “Yes, I would tell him not to drive. And he’s our driver right now, running our country.”
I couldn’t shake it. “That really... you’re a neurologist, and that’s striking to me in a very disturbing way.”
There was a long, heavy pause, and I said, “Honestly, it gives me the chills.” I had to tell her the truth about the words she’d shared with me. I had to process what she’d said in that moment. This man, after all, has the nuclear codes at his fingertips.
We both agreed that he’s a danger to all of us, and I regained my composure to ask her how long she thought Trump had left, given his declining state. Even though the question wasn’t a hard one, for some reason, I struggled to articulate it, but I finally uttered it, “How long does he have left?” The question was palpable.
“He can’t sustain this another 4 years. He could die, because he is old enough... Right now, they are trying to hide it. They can’t get through another 4 years of this. It’s getting bad fast, and it’s noticeably worse in the last 6 months. Plus, it’s accelerating, yeah, I don’t think it’s sustainable. Something is going to have to give, whether he is taken out of office or he just dies of natural causes—I don’t think he’ll make it through another 4 years of this.”
I listened carefully and now knew exactly what to ask for my final question: “What do you think it’s going to look like in 6 months?”
Dr. Faber was blunt: “I think they won’t be having him do public events. They’ll have him under wraps. They might have a reason why he won’t continue his job.”
I closed by saying to her that watching him decline might not be stunning to her, since her job is to witness the cognitive decline of patients. But she disagreed and said, “Well, it is stunning, because it is affecting the whole world.”
This parable, written by Al Wilson, an African American soul singer, was distorted and perverted through Trump’s white nationalist lens. For example, at a rally on March 16, 2016, in Vienna, Ohio, then-presidential candidate Trump told the crowd that he wanted to read something to them, the parable of the Snake being taken in by the “tender-hearted woman,” who then turned around only to bite her on her bosom mortally. Here’s the parable:
On here way to work one morning
Down the path along the lake
A tender-hearted woman saw a poor half-frozen snake.
His pretty colored skin had been all frosted with the dew.
‘Oh well,’ she cried, ‘I’ll take you in, and I’ll take care of you.’
‘Take me in oh tender woman
Take me in, for heaven’s sake
Take me oh tender woman,’ sighed the broken snake.
She wrapped him up all cozy in a curvature of silk
Then laid him by the fireside with honey and some milk
Now she hurried home from work that night as soon as she arrived,
She found that pretty snake she’d take in had been revived. She was happy.
‘Take me in, oh tender woman.
Take me in, oh heaven’s sake.
Take me in oh tender woman,’ sighed the broken snake.
Now she clutched him to her bosom, ‘You’re so beautiful,’ she cried.
‘But if I hadn’t brought you in by now, heavens, you might have died.’
Now she stroked his pretty skin and then she kissed him and held him tight.
But instead of saying thank you, that snake gave her a vicious bite!
‘Take me in, oh tender woman,
Take me in, for heaven’s sake,
Take me in oh tender woman,’ sighed the vicious snake.
‘I saved you,’ cried that woman,
‘And you bit me heavens why?
You know your bite is poisonous and now I’m going to die!’
‘Oh shut up, silly woman,’ said the reptile with a grin.
‘You knew damn well I was a snake before you took me in.’
Quoted from Alexander Laban Hinton, It Can Happen Here: White Power and the Rising Threat of Genocide in the U.S. (New York, New York: NYU Press, 2021), 2-3.
Dr. Faber here! Thanks so much Cryn for the opportunity to share my thoughts. Another great article. I especially love that you included your corgi. And the snake story.
It is clear to me, it is time to take the keys away from daddy.
The constitution requires people to be at least 35 years old to have some maturity.
After the last two presidents, we need to amend that to limit the age of the president to 70 or so. What are we waiting for??